Toppik on 1 December 2014

Why is it that people only lose hair from the front, top and crown?

When referring to hair loss, it is commonly called male or female pattern baldness because there is a distinct and predictable pattern to it. The follicles that grow hair at the front, top and crown are genetically programmed to be affected and eventually wither and die under the influence of DHT. The follicles at the back of the scalp are generally resistant to the effects of DHT and continue to grow hair well into advanced old age.

Lots of people I see down at the beach who are hairy all over their backs, chests and upper arms also suffer hair loss. Is there a correlation?

Yes. While DHT shrinks the hair follicles on the head, it is believed to have the opposite effect on the body, actually stimulating hair growth on the back, chest and upper arms.

Do some races suffer hair loss more than others?

In my practice I have noticed that young men of southern European descent, particularly Greeks and Italians, are more prone to hair loss than others. Interestingly, women from the same region also appear more susceptible to hair loss, often having more facial and body hair that is considered normal, as well.

Can I transplant hair from other parts of the body?

No. The hair that grows in other areas of the body is a different colour, length and texture and would not provide the natural appearance that we strive for.

Can I transplant hair from other people?

It was long believed that the recipient’s immune system would kill off the donated skin. This has since been proven incorrect in laboratory trials; however, you would find it difficult to find a donor and also to find a doctor to perform the procedure, because the results of the trials were inconclusive.

How important to the final result is the quality and density of my donor area at the back?

The type and strength of the donor hair at the back of the scalp will ultimately determine how good a result you will achieve in the recipient area. If a person has weak, fine hair the result they will achieve will be weak and fine. Conversely, an individual with thick, strong, dense hair will achieve a much thicker final result.

How much pain is involved during the procedure?

There is a degree of discomfort when having a procedure. From pain management surveys I have conducted with past patients, it is clear that almost 100% anticipated the procedure to be far more painful than it actually was. When I had my own procedure performed, I found it no worse than having dental surgery.

Can I be put to sleep during the procedure?

This is possible; however, with the minimal pain involved in a hair transplant procedure, it is hard to justify the extra expense and inconvenience that the use of a hospital and a specialist anaesthetist would require. General anaesthesia also carries with it increased risk.

Will I have a bald patch at the back of my head?

No. The donor area at the back of the scalp is simply pulled back together and held in place with stitches. Most scars are approximately 2mm wide and easily concealed by the patient’s lifetime hair at the back and sides. Individual scars may vary.

How thick a result can I achieve?

This will depend on many factors, such as the number of grafts available, the size of the area to fill, the individual hair shaft density, the contrast between hair and skin colour, and hair curl. Other variables also need to be taken into account and it is really only possible to determine a likely outcome at a consultation. Those considering going ahead are also advised to meet previous patients and view achievable densities first hand.

Can I achieve a full growing result in one procedure?

This depends upon the amount of hair loss you have suffered. If we are attempting to fill the frontline all the way through the midscalp and the crown, I consider about 5,000 grafts to be the minimum. This would be conducted as two procedures. Smaller areas may be able to get away with one procedure only. As mentioned previously, the type of donor hair you have will also be a factor.

Are all hair transplants successful?

Doctors attempt to assess how successful their work has been all the time. Ultimately, though, only the patient can answer that question. Have I fulfilled my expectations? If, 12 months after the procedure, you can answer yes, then the transplant has been a success. To ensure that your hair transplant is a success, you should investigate all your options and make sure what you are being offered is achievable and your expectations are realistic. Talk to past patients and see their results.

Will there be any scarring?

Yes. Any hair transplant procedure requires that the skin be cut, resulting in scar tissue. However, follicular unit grafting uses very small incisions and any scarring in the recipient area is generally invisible to the naked eye. There will also, of course, be a scar from the donor area at the back of the scalp, but the existing hair will hide this. If prospective patients are concerned about scarring, they are advised to see examples of individual surgeon’s work before commencing any treatment.

How soon can I return to work?

Many people who have a procedure take around 7-10 days off.

Can I wear a hairpiece while the hair transplant grows through?

Yes. It is possible for wearers of existing hairpieces to continue wearing the hairpiece on a temporary basis after the procedure.

How soon will I see the results of the procedure?

For some people the grafts grow immediately; however, these people are the exception. In most cases, the hair grafts will go into a resting phase and shed, with new growth appearing three to four months after and a final result expected within 9-12 months.

Is there any special maintenance required of my new hair?

No. Transplanted hair is just your own growing hair moved to a different position on your head. You can go to your hairdresser for a haircut and use any commercially available shampoo. In short, just treat it as you did your old hair.

How do I know my new hair won’t fall out like my old hair did?

We know that the hair from the back of the scalp does not wither and die under the effects of DHT. It will therefore grow and continue to grow in its new position and will not bald as the old hair did. The results from procedures done up to 40 years ago attest to this fact.

How do I know I won’t end up looking like those older-style procedures?

Hair transplant procedures have made incredible advances over the last twenty years and in particular the last five years. The results from the latest follicular unit grafting allows us to recreate an incredibly natural hairline. This area was always the Achilles heel of older-style procedures – the area they found the most difficult to mirror nature in. Performed correctly, it is now possible to recreate a very natural hairline and relatively strong, full hair behind this area.